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  • Title: Nonimmune "Fulminant" type 1 diabetes presenting with diabetic ketoacidosis during pregnancy.
    Author: Otsubo M, Shiozawa T, Kimura K, Konishi I.
    Journal: Obstet Gynecol; 2002 May; 99(5 Pt 2):877-9. PubMed ID: 11975942.
    Abstract:
    BACKGROUND: Ketoacidosis in pregnant women with previously undiagnosed diabetes is rare. Although insulin-dependent diabetes has recently been classified as either autoimmune (type 1A) or nonimmune (type 1B; "chronic" and "fulminant" subtypes), the clinical characteristics of diabetes in such settings are not fully understood. CASE: We report two pregnant patients with previously undiagnosed diabetes. They presented with severe diabetic ketoacidosis characterized by an abrupt onset, normal, or slightly elevated level of glycosylated hemoglobin, absence of diabetes-related autoimmune antibodies, and features typical of the "fulminant" subtype of nonimmune diabetes. The fetuses died in utero, and the mothers became insulin dependent. CONCLUSION: The "fulminant" subtype of diabetes may be associated with fetal death.
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